Anderson B
Senior Citizen's Health Center, St. Luke's Hospital, Denver.
Nurse Pract. 1991 Dec;16(12):39-47.
Asthma involves bronchoconstrictor mechanisms, possible abnormalities of airway smooth muscles and an inflammatory response. Past emphasis on bronchodilator therapy ignored the underlying inflammatory response. Since chronic asthma can eventually lead to irreversible airflow obstruction from uncontrolled inflammation, current drug therapy stresses both inflammation reduction and bronchodilatation. This article discusses the rationale of current pharmacologic management for the adult client with chronic asthma and presents a step-care approach for management of the disease. Inhaled beta-agonists--effective bronchodilators--are the primary drug of choice. Steroids administered via inhalation are the most effective anti-inflammatory agents available. Cromolyn sodium is useful for prophylactic management of asthma. Theophylline, previously the cornerstone of asthma treatment, is now introduced later in the therapeutic plan as an additional bronchodilator. Inhaled anticholinergics may be tried as adjunctive asthma treatment. With careful assessment, intervention and management, health care providers can successfully care for most adult clients with chronic asthma.
哮喘涉及支气管收缩机制、气道平滑肌可能存在的异常以及炎症反应。过去对支气管扩张剂疗法的重视忽略了潜在的炎症反应。由于慢性哮喘最终可能因炎症控制不佳导致不可逆的气流阻塞，目前的药物治疗强调减轻炎症和支气管扩张。本文讨论了成年慢性哮喘患者当前药物治疗的基本原理，并提出了该疾病的分步护理方法。吸入型β受体激动剂——有效的支气管扩张剂——是主要的首选药物。通过吸入给药的类固醇是现有的最有效的抗炎药物。色甘酸钠对哮喘的预防性治疗有用。茶碱以前是哮喘治疗的基石，现在在治疗方案中稍后引入作为额外的支气管扩张剂。吸入型抗胆碱能药物可作为哮喘辅助治疗尝试使用。通过仔细评估、干预和管理，医疗保健提供者能够成功护理大多数成年慢性哮喘患者。
